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If you’re like a lot of people, you may be looking forward to a forecast of snow—and some great conditions on the slopes.

For a select few, those hopes may take a downhill slide. Literally.

Knee injuries are the most common type of injury suffered by skiers and snowboarders, accounting for 25 percent to 40 percent of all injuries, according to the U.S. Department of Health and Human Services. And one of the most common knee injuries is an anterior cruciate ligament (ACL) sprain or tear.

The cruciate ligaments—the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL)—form an “X” inside your knee. Together, these ligaments control your knee’s back and forth movement.
Too much stress on these ligaments can cause them to stretch too far—or even snap. Most of the time, injury occurs by changing direction rapidly, stopping suddenly, slowing down while running, or landing incorrectly from a jump. Injury can also occur as a result of direct contact or collision.

The bad news: the ACL and the PCL cannot be repaired; once they are torn or stretched beyond their limits, the only treatment is surgical reconstruction.

Luckily, according to Dr Ramappa, the surgery is very successful. “Our surgical techniques have evolved, even over the last few years,” he says. The procedure only takes about an hour to do, and it’s all done arthroscopically. Most patients will eventually be able to return to their previous level of activity.

“Typically, if you have an ACL injury, you will be able to resume skiing,” Dr. Ramappa says. “Bode Miller tore his ACL in 2001 and he’s back skiing. For most patients, it’s not a problem.”

And while surgery may seem drastic for some, Dr. Ramappa recommends having ACL tears reconstructed–wearing a brace won’t give you the necessary level of support if you plan to return to the slopes.

“Skiing with a tear is risky,” he says. “Even if you’re wearing a brace, your knee remains at a high risk for injury if you don’t have an ACL.”

Recovery time from the surgery is typically about six to nine months. Dr. Ramappa points out, however, that participating in a rehabilitation program is crucial.

“Rehab is critical,” he says. “If you don’t do it, you won’t have a good outcome. It’s as simple as that.”
Now, how can you protect yourself from getting injured in the first place? Dr. Ramappa recommends plain old common sense.

“It’s not complicated,” he says. “Ski in good conditions, ski on trails that are match your skill level, and probably most importantly, if you’re tired or fatigued, stop skiing. Injuries are most likely to happen near the end of the day, so if you’re tired, it’s better to back off.”

Oh, and if you’re not Bode Miller, listen up: “Remember, you need to prepare for ski season, you can’t just jump off the couch and go,” Dr. Ramappa says. “You need to get in shape and do some strength training so that you’re physically ready.”